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Prevalence of dyslipidemic phenotypes in ischemic heart disease (prospective results from the Que´bec cardiovascular study)

  • Author Footnotes
    1 Lamarche is a recipient of a fellowship from the Medical Research Council of Canada.
    Benoiˆt Lamarche
    Footnotes
    1 Lamarche is a recipient of a fellowship from the Medical Research Council of Canada.
    Affiliations
    From the Lipid Research Center, CHUL Research Center, Laval University, Ste-Foy Canada

    From the Department of Medicine, University of Montre´al, Montre´al ,Canada
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  • Jean-Pierre Despre´s
    Correspondence
    Address for reprints: Jean-Pierre Despre´s, PhD, Lipid Research Center, CHUL Research Center, 2705 Laurier Boulevard, Ste-Foy, Que´bec ,CanadaG1V 4G2.
    Affiliations
    From the Lipid Research Center, CHUL Research Center, Laval University, Ste-Foy Canada

    From the Department of Medicine, University of Montre´al, Montre´al ,Canada
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  • Sital Moorjani
    Affiliations
    From the Lipid Research Center, CHUL Research Center, Laval University, Ste-Foy Canada

    From the Department of Medicine, University of Montre´al, Montre´al ,Canada
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  • Bernard Cantin
    Affiliations
    From the Lipid Research Center, CHUL Research Center, Laval University, Ste-Foy Canada

    From the Department of Medicine, University of Montre´al, Montre´al ,Canada
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  • Gilles R. Dagenais
    Affiliations
    From the Lipid Research Center, CHUL Research Center, Laval University, Ste-Foy Canada

    From the Department of Medicine, University of Montre´al, Montre´al ,Canada
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  • Paul-J. Lupien
    Affiliations
    From the Lipid Research Center, CHUL Research Center, Laval University, Ste-Foy Canada

    From the Department of Medicine, University of Montre´al, Montre´al ,Canada
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  • Author Footnotes
    1 Lamarche is a recipient of a fellowship from the Medical Research Council of Canada.
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      Abstract

      In 1985, plasma cholesterol, triglyceride, high-density lipoprotein cholesterol, and plasma apoprotein (apo) B levels were measured in 2,103 men (aged 45 to 76 years) without ischemic heart disease from the Que´bec city suburbs. Occurrence of a first ischemic event (i.e., angina pectoris, acute myocardial infarction, or coronary-related death) was recorded in 114 men between 1985 and 1990. Men with and without ischemic heart disease were classified as normal or in various dyslipidemic groups according to an established algorithm. Of the 1,989 men who remained free of ischemic events, 50% had a normal lipid profile compared with 32% in men with ischemic heart disease. Although the prevalence of type IIb and IV dyslipidemias was similar in men with and without ischemic heart disease, type lia (16% vs 10%), hyperapo B-hypertriglyceridemia (12% vs 6%), hyperapo B-normotriglyceridemia (11% vs 7%), and hypoalphalipoproteinemia (18% vs 13%) were more prevalent in men with than without ischemic heart disease. Adjusted odds ratios (ORs) were not increased in type IIb and IV phenotypes, whereas men with type IIa (OR 2.8), with the 2 hyperapo B phenotypes (hyperapo B-normotriglyceridemia, OR 2.7; hyperapo B-hypertriglyceridemia, OR 3.1) or with isolated hypoalphalipoproteinemia (OR 2.2), were at higher risk. The results of this prospective study confirm the importance of both elevated plasma cholesterol and decreased high-density lipoprotein cholesterol levels as risk factors for ischemic heart disease. They also emphasize the high prevalence of an elevated apo B dyslipidemic state in ischemic heart disease.
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      Reference

        • Castelli WP
        Epidemiology of coronary heart disease: The Framingham Study.
        Am J Med. 1984; 76: 4-12
        • Stamler J
        • Wentworth D
        • Neaton JD
        Is the relationship between serum cholesterol and risk of premature death from coronary heart disease continuous and graded? Findings in 356,222 primary screenees of the Multiple Risk Factor Intervention Trial (MRFIT).
        JAMA. 1986; 256: 2823-2828
        • Martin MJ
        • Hulley SB
        • Browner WS
        • Kuller LH
        • Wentworth D
        Serum cholesterol, blood pressure, and mortality: implications from a cohort of 361,662 men.
        Lancet. 1986; 2: 933-936
        • Genest JJ
        • McNamara JR
        • Salem DN
        • Schaefer EJ
        Prevalence of risk factors in men with premature coronary heart disease.
        Am J Cardiol. 1991; 67: 1185-1189
        • Miller GJ
        • Miller NE
        Plasma high density lipoprotein concentration and development of ischaemic heart disease.
        Lancet. 1976; 1: 16-18
        • Sniderman A
        • Shapiro S
        • Marpole D
        • Skinner B
        • Teng B
        • Kwiterovich Jr, PO
        Association of coronary atherosclerosis with hyperapobetalipoproteinemia (increased protein but normal cholesterol levels in human low density lipoproteins).
        in: 6th ed. Proc Natl Acad Sci USA. 77. 1980: 604-608
        • Sniderman AD
        • Wolfson C
        • Teng B
        • Franklin FA
        • Bachorik PS
        • Kwiterovich Jr, PO
        Association of hyperapobetalipoproteinemia with endogenous hypertriglyceridemia and atherosclerosis.
        Ann Intern Med. 1982; 97: 833-839
        • Kwiterovich PO
        • Coresh J
        • Bachorik PS
        Prevalence of hyperapobetalipoproteinemia and other lipoprotein phenotypes in men (aged ≤50 years) and women (≤60 years) with coronary artery disease.
        Am J Cardiol. 1993; 71: 631-639
        • Dagenais GR
        • Robitaille NM
        • Lupien PJ
        • Christen A
        • Gingras S
        • Moorjani S
        • Meyer F
        • Rochon J
        First coronary heart disease event rate in relation to major risk factors. Quebec Cardiovasular Study.
        Can J Cardiol. 1990; 6: 274-280
        • Chait A
        • Brunzell JD
        Chylomicronemia syndrome.
        Adv Intern Med. 1992; 37: 249-273
        • Castelli WP
        • Garrison RJ
        • Wilson PWF
        • Abbott RD
        • Kalousdian S
        • Kannel WB
        Incidence of coronary heart disease and lipoprotein cholesterol levels: The Framingham Study.
        JAMA. 1986; 256: 2835-2838
        • Gillum RF
        • Fortmann SP
        • Prineas RJ
        • Kottke TE
        International diagnostic criteria for acute myocardial infarction and acute stroke.
        Am Heart J. 1984; 108: 150-158
        • Leon L
        • Turrell J
        • Rush RF
        Automated simultaneous cholesterol and triglyceride determination on the autoanalyzer II instrument.
        Technicon Instrument Corporation, Tarrytown, NY1972
        • Albers JJ
        • Warnick GR
        • Wiebe D
        • King P
        • Steiner P
        • Smith L
        • Breckenridge C
        • Chow A
        • Kuba K
        • Weidman S
        • Arnett H
        • Wood P
        • Shlagenhaft A
        Multi-laboratory comparison of three heparin-Mn2+ precipitation procedures for estimating cholesterol in high-density lipoproteins.
        Clin Chem. 1978; 24: 853-856
        • Friedewald WT
        • Levy RI
        • Fredrickson DS
        Estimation of the concentration of low density lipoprotein cholesterol in plasma, without use of the preparative ultra-centrifuge.
        Clin Chem. 1972; 18: 499-502
        • Laurell CB
        Quantitative estimation of proteins by electrophoresis in agarose gel containing antibodies.
        Ann Biochem. 1960; 5: 609-610
        • Moorjani S
        • Dupont A
        • Labrie F
        • Lupien PJ
        • Brun LD
        • Gagne´ C
        • Gigue´re N
        • Be´langer A
        Increase in plasma high density lipoprotein concentration following complete androgen blockage in men with prostatic carcinoma.
        Metabolism. 1987; 36: 244-250
        • Rifkind BM
        • Segal P
        Lipid research clinics program reference values for hyperlipidemia and hypolipidemia.
        JAMA. 1983; 250: 1869-1872
      1. Canadian Consensus Conference on Cholesterol: final report.
        in: Canadian consensus conference on the prevention of heart and vascular disease by altering serum cholesterol and lipoprotein risk factors. 6th ed. Can Med Assoc J. 139. 1988: 1-8 (suppl II)
        • Genest Jr, J
        • McNamara JR
        • Ordovas JM
        • Jenner JL
        • Silberman SR
        • Anderson KM
        • Wilson PWF
        • Salem DN
        • Schaefer EJ
        Lipoprotein cholesterol, apolipoprotein A-I and B and lipoprotein (a) abnormalities in men with premature coronary artery disease.
        J Am Coll Cardiol. 1992; 19: 792-802
        • Scandinavian Simvastatin Survival Study Group
        Randomized trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S).
        Lancet. 1994; 344: 1383-1389
        • Austin MA
        • King MC
        • Vranizan KM
        • Krauss RM
        Atherogenic lipoprotein phenotype. A proposed genetic marker for coronary heart disease risk.
        Circulation. 1990; 82: 495-506
        • Austin MA
        Plasma triglyceride and coronary heart disease.
        Arterioscler Thromb. 1991; 11: 2-14
        • Hulley SB
        • Rosenman RH
        • Bawol RD
        • Brand RJ
        Epidemiology as a guide to clinical decision: the association between triglyceride and coronary heart disease.
        N Engl J Med. 1980; 302: 1383-1389
        • Miller M
        • Mead LA
        • Kwiterovich PO
        • Pearson TA
        Dyslipidemias with desirable plasma total cholesterol levels and angiographically demonstrated coronary artery disease.
        Am J Cardiol. 1990; 65: 1-5
        • Ginsburg GS
        • Safran C
        • Pasternak RC
        Frequency of low serum high-density lipoprotein cholesterol levels in hospitalized patients with desirable total cholesterol levels.
        Am J Cardiol. 1991; 68: 187-192
        • Rubins HB
        • Schectman G
        • Wilt TJ
        • Iwane MK
        Distribution of lipid phenotypes in community-living men with coronary heart disease. High prevalence of isolated low levels of high-density lipoprotein cholesterol.
        Arch Intern Med. 1992; 152: 2412-2416